July 2017 Vol. 5 No.7

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Original Research Article

Serum hepcidin, ferritin, MPO and M2-PK in inflammatory and tumor bowel diseases

Manolov Victor^1*, Petrova Julia², Hadjidekova Savina³, Georgiev Ognyan⁴, Stefanova-Petrova Diana⁴, Tzryncheva Radoslava⁴, Vasilev Vasil⁵, Petrova Maria², Kunchev Todor², Jelev Yavor², Jeliazkov Petar⁷, Marinov Borislav⁶, Gramatikova Zlatina⁷, Tzatchev Kamen¹, Traykov Latchezar² and Mitev Vanio⁸

¹Medical University, Sofia; Dept. of Clinical laboratory and clinical immunology
²Medical University, Sofia; Dept. of Neurology
³Medical University, Sofia; Dept. of Medical genetics
⁴Medical University, Sofia; Dept. of Propaedeutic of internal diseases
⁵University “Aleksandrovska” hospital, Sofia; Clinical laboratory and clinical pharmacology
⁶Medical University, Sofia; Dept. of Obstetrics and Gynaecology
⁷R.E.D. Laboratories N.V./S.A. – Zellik, Belgium
⁸Medical University, Sofia; Dept. of Medical chemistry and biochemistry

*Corresponding Author’s E-mail: victhedoc4@abv.bg
Phone: +35929230928

Accepted June 14, 2017

Abstract

Anemia is one of the most common symptoms not only in inflammatory bowel diseases, but in gastrointestinal cancer. New studies mark hepcidin as key iron metabolism regulator, blocking ferroportin, the only intracellular iron exporter. The main reason for hepcidin elevation is described as inflammation in ulcerative colitis and crohn’s disease, and gastrointestinal tumor, which is connected to inflammatory cytokines, as interleukin-6. In latest years, ferritin is described as part of metabolomics of many neurodegenerative, tumor, and inflammatory diseases. We evaluated 30 patients with inflammatory bowel disease (IBD) and 19 Patient s with gastrointestinal tumor diseases in Clinic of Gastroenterology at University "Aleksandrovska" hospital; average age 51.9 ± 5.6. From 19 patients with gastrointestinal tumours, 52.6% were with stomach cancer, 47.4% with bowels intestinal cancer. Their results were compared to 49 age matched controls. Included both groups were measured for complete blood count (CBC) (on ADVIA 2120, by Siemens Healthcare), routine biochemical parameters, including Ferrozine iron and ferritin (on Dimension RxL MAX, by Siemens Healthcare), soluble transferrin receptors (by nephelometric method), hepcidin, myeloperoxidase (MPO), M2-pyruvatkinase (M2-PK) and interleukin-6 (IL-6) (by (ELISA methods). Correlations and significance were rated by Student’s paired t-test and Pearson’s correlation. Our study had showed elevated serum hepcidin levels in both IBD patients (61.1 ± 13.1µg/L), and in cases with gastrointestinal tumour (90.9 ± 12.1µg/L) compared to control group (21.5 ± 5.1 µg/L); P<0.001. Serum ferritin concentrations were elevated in IBD (261.1 ± 16.3 ng/mL) and gastrointestinal tumour cases (280.7 ± 20.0 ng/mL) compared to controls (198.7 ± 21.4 ng/mL); P<0.005. In both groups, we found increased MPO and M2-PK concentrations (MPO: 552.6 ± 99.7 ng/mL, and M2-PK: 88.9 ± 10.7 ng/mL) compared to healthy controls (194.7 ± 10.8 ng/mL, and 19.8 ± 1.7 ng/mL, resp.); P<0.001. MPO and M2-PK were correlated strongly and positively to serum hepcidin in patients with IBD and gastrointestinal tumour (r=0.670, and r=0.693; P<0.001). Ferritin was correlated positively to IL-6 concentrations in both groups as well (r=0.703, P<0.005). Increased iron is involved in production of free reactive radicals with pro-inflammatory effect in rectal, liver and prostate cancers. High hepcidin concentration is due to inadequate erythropoietin therapy in tumor diseases. Influence of hepcidin synthesis might be a new therapeutic tool for anemia diagnosis and treatment in patients with IBD and gastrointestinal tumor diseases. Hepcidin quantification is important for individual approach in anemia treatment and therapy efficacy.

Key words: Chron’s disease, ferritin, hepcidin, inflammation, interleukin-6, iron homeostasis, stomach tumour, ulcerative colitis